Getting Used to an Insulin Pump

Posts tagged ‘Exercise’

The … Diabetic

The ... Diabetic

The … Diabetic

I received an e-mail the other day relating to playing volleyball with an insulin pump and thought that the questions and my answers may be relevant, not only to volleyball but to a lot of other sports and activities.

I asked the nice young lady if she’d mind me using it for a blog post and she said that was okay as long as I used her pen name which is The … Diabetic, She writes her own blog (click on that link to get to it). I’ve also changed her e-mail address for the one she requested so feel free to contact her if anything on her pages floats your boat.

Date: Tue, 5 Feb 2013 14:43:08 -0800
From: the_3dots_diabetic@yahoo.com
Subject: Insulin Pumps and Volleyball
To: NottsType1@hotmail.co.uk

Hi Dan,

I came across your blog when doing some research on insulin pumps and playing volleyball. I’m quite interested in getting an insulin pump, but am only at the start of my investigations. I have an appointment with a Pump Doctor at my local clinic in a few weeks time, so I’m trying to do some homework beforehand and be prepared at the appointment!

I’m quite a keen volleyball player. I train 2 hours on 3 nights each week, I help coach juniors for 1 hour on one of these nights (before training), and play matches on a Saturday. Depending on the match schedule, I sometimes play on a fourth night in the week too.  I guess my main worry is how well infusion sets stay in place when jumping, blocking, hitting and diving, as well as how easy it is to avoid a pump getting damaged whilst throwing myself around court.  Would you be able to give me a bit of insight? Do you disconnect your pump? Have you had problems with air getting into sets or sets coming dislodged? From your blog, I gather you’re using a Roche Spirit Combo – has it been a positive experience? Where do you put it when on court? Finally, did you have to ask permission from the referees commision to play with a pump at matches?

Apologies about the million questions, there aren’t many testimonies out there of people playing volleyball with their pumps, and providing details on how they manage, so any extra insights would be much welcomed.

Kind regards,
The … Diabetic

My Response:

From: Type 1 Diabetic <nottstype1@hotmail.co.uk>
To: The … Diabetic <the_3dots_diabetic@yahoo.com>
Sent: Wednesday, 6 February 2013, 16:34
Subject: RE: Insulin Pumps and Volleyball

Alright The … Diabetic,

I’ve actually quit volleyball temporarily for a number of reason’s, none of which, I’m sure you’ll be pleased to hear, are to do with the pump!

So to answer your questions as best as I can:

1. My infusion set always stayed in fine while playing, I chose the Accu-Chek TenderLink when I started off pump therapy but have changed to the FlexLink, both of these have a flexible cannula but the TenderLink goes in at an angle which I thought would protect it better from bumps while playing, however I am on the thin side (about five foot eight (1.72m) and 10 and a half stone (65kilos)) and I found after a bit of use my stomach looked like a pincushion. The FlexLink ones are, in my opinion, if anything a little hardier and come with the added bonus of the Link Assist Insertion Device which works like a kind of staple gun to get it in to you (honestly, better than it sounds!!!). If you have a preference for which side you dive on it might be worth considering that when placing infusion sets but with the amount you play your probably better just to stick it in and see how it goes. Certainly reaching up for blocks and the force of hits seemed to have no effect on the set staying put!

2. I have a neoprene pouch with a loop to feed the velcro elastic strap that came with it through, not sexy but worked for me, however you sound like you play pretty intensely so it might be worth you looking at the hard case along with sports belts here. I wore my pump on my back turned so it ran vertically up my spine, more or less, so there was little chance of me falling on it, kept it on the whole time and didn’t have any problems with bits falling off or coming loose.

3. Keep it plugged in pretty much all the time, only time it comes off is when I shower or swim.

4. Never had problems with air getting in, they are pretty well sealed units, although when I got it I was warned that I should keep checking the tightness of where the pump connects to the cannula and I now do that pretty much as standard without even thinking about it.

5. The Accu-Chek Combo has been brilliant for me, although I suspect that there are probably better pumps out there already, I’ve had it nearly two years now after all. This site is pretty good for the latest info, but as above it’s probably worth checking what accessories you can get when trying to make a decision, it might also be influenced by your healthcare team but frankly I have a lot of friends on various pumps and no one has been disappointed!

6. Never even thought to ask the referees, although I did check with my coach as well as my Diabetes consultant, whether they thought I needed to consider taking any action other than what I had already decided (e.g. wearing it strapped on and on my back while playing) and they both said it should be fine.

If there is anything else I can help you with, Volleyball related or otherwise please drop me a line, I’m always happy to help.

By the way is it okay if I use your e-mail and my response in a blog post? I suspect this information would be useful to a lot of people!

Cheers

Dan

Web-Monkey
Nottingham Type 1 Diabetes Group
I’m Gonna Stick You!!!

Hope you all find that useful!

Toothbrush, Boots and a Memory Man

Boots The Chemist...and whatever else they do these days!

Boots The Chemist…and whatever else they do these days!

When I have a shower in the morning I tend to leave my insulin pump in my dressing gown pocket and then plug myself back in as soon as I’m dry and have something to clip it on to again. You may wonder why I’m telling you this, don’t worry hopefully it’ll become more obvious as the events of today unfold!

I was busy doing some important stuff at work this morning and I’d not bothered making any lunch as I thought I’d have a quick trip away from my computer to Boots in town to grab something. Because it had been busy I hadn’t done a  blood test since breakfast time.

So, one o’clock arrived and I headed out in to the frankly unpleasant weather, swiftly walking the five minutes or so in to try and avoid getting too damp. I got to Boots, picked a “”Delicious” Cheese & Pesto Pasta Salad”, a packet of healthy-ish crisps and a bottle of Diet Coke, then I headed over to the dental bit ’cause I need a new head on my electric toothbrush. I paid up and left heading in to the Victoria Centre to find somewhere to sit and have my lunch.

First thing I did was look at the food I had bought to see how many carb’s I needed to wind up on my pump, I was a little upset to find that Boots have re-branded their “”Delicious” Cheese & Pesto Pasta Salad” so it doesn’t actually tell you what the carbohydrate content is. After searching all over the packet many times I resolved to guess at the contents and adjust after getting back to a computer that I could look it up on (Web-Monkey without his own smartphone – funny I know!).

I did a blood test, as I always do before eating. I was a little surprised to find my BM was at 15.6mmol/l. “Hmm, that’s a little odd” I thought, that new bread must have a lot more carb’s in than it says on the packet. Anyway I wound up the CHO and hit the bolus button to which I was greeted by a “communication error” message. I cancelled out and tried it again and it did the same thing. Then I had one of those moments when you realise what the problem actually is. I patted myself down and realised that the reason I was getting a communication error was because my insulin pump was about two and a half miles away in my dressing gown pocket at home!

I ran back to work, carrying my carbohydrate-camouflaging salad, crisps, drink and toothbrush heads, grabbed my keys from my bag, excused myself and ran to get the bus home.

I got home in a little under fifteen minutes, which isn’t bad going, surprised Deanne who works from home on a Monday, plugged myself in and did a blood test, I’d dropped a little to 15mmol/l, which must have been a mix of the residual insulin and the running to get the bus. Gave Deanne a quick peck on the cheek and ran out the door again.

Getting back to work I looked up the “”Delicious” Cheese & Pesto Pasta Salad”, (56 grams in case you’re interested), wound up the total on my pump and bolused as quickly as I could.

Sadly after being unplugged for about six hours my blood sugar hasn’t yet normalised and I suspect if anything I’ll get a sudden drop at about six o’clock this evening.

When I had sorted myself out to my own satisfaction I posted a message on the Boots UK Facebook page, and to give them their due they actually told me they would look in to a way of including all the details on the back of the packet, you can see my overly sarcastic posting and their responses here if you’re interested.

Anyway, it was a stupid thing to do and closely aligned with last weeks stupidity of bringing my insulin to work ’cause I knew it would run out before the end of the day but forgetting to bring a cartridge in which to put said insulin!

All in all I seem to be having a couple of slow brain weeks, I’m hoping it won’t last much longer!

Ooh, Pointy!

When I was at the clinic the other week for my annual pump check up I asked if I could try a different infusion set, because my stomach looks a little like it has a bad case of acne from the places where the needles have been. My pump is an Accu-Chek Spirit Combo and I’ve used the TenderLink infusion set since I got it because I thought having the bit that sticks in to me at an angle rather than at 90 degrees would be better for e.g. when I was playing volleyball and such like.

Anyhoo, I was given the only one they happened to have a few of laying around which was the Ultraflex, this one has a needle which goes straight in to you but is much shorter and (I think!?!?!) thinner than the TenderLink. Anyway I got four of them and so I used them over the previous couple of weeks, then last night I went back to the old standard.

I have put a picture of both below, the old one on the left and the new one on the right and I just wanted to say that the old one now feels like trying to stick Cleopatra’s Needle in to myself. Sadly I have about three or four boxes of the TenderLinks left and I don’t believe in needlessly sucking money out of the good old NHS so I’ll use them up first but when I next give those nice people at Roche Diagnostics a call I’ll be changing my standard order to the FlexLink infusion sets!

Accu-Chek FlexLink Infusion Set

Accu-Chek FlexLink Infusion Set

Accu-Chek TenderLink Infusion Set

Accu-Chek TenderLink Infusion Set

Ban(ne)d

Tomorrow night I’m trying out with a band, they want a guitarist and I kinda play guitar…badly, or at least I used to about four years ago. Here’s a picture to prove it:

Me, Playing Guitar!

Me, Playing Guitar!

As I say I’m a little out of practice and probably need a few go’s before I can actually play along with their music so I’m hoping they’ll be patient.

Anyway last time I lived the rock ‘n’ roll lifestyle I was using a pen to inject four or five times a day, I didn’t do carb’ counting and I frankly managed my diabetes by crossing my fingers and having a lot of hypos and highs so I’m hoping it’s going to be a bit easier what with all this modern technology I’ve managed to persuade the medical establishment to supply me with.

However What I do have now is of course plugged in to my belly 24/7 and also has a three thousand quid piece of kit hanging off me, this is why I’m going to have to think carefully about my set-up before I head out of the house tomorrow night. I think I’m due an infusion set change tomorrow night so I’ll probably do that before I go, this means I need to pick a spot…and a side of myself that will cause the smallest inconvenience in terms of catching cannula on sticky out bits of guitar or continually rubbing said guitar over infusion set and causing discomfort.

Further to this is of course the fact that I have experienced most things which come up in every day situations since getting the pump, however I haven’t stood up for a couple of hours with a frankly rather heavy guitar (I own one of these now) which weighs about nine pounds, that’s about four kilo’s if you’re a youngster! Also there’s the unpleasantness of hefting guitars, pedals and even worse amplifiers up and down stairs to practice rooms and back to your car afterwards.

So with all these things considered am I having second thoughts about going tomorrow night?

Don’t be silly,  I’ll just do a lot of blood test before, during and after and hope Im lucky enough not to stab a finger so it hurts when I press the strings down, if I do I’ll just have to live with the pain. I’ll just make sure they are all aware that if I play particularly badly it may be a mixture of nerves, not having practised properly for about three years and low blood sugar all combined in to an ear splitting wall of feedback and noise. Or maybe that’s what they want???

Wish me luck 😉

Australia – A Really Badly Written Travelogue

Some Native Wildlife

Some Native Wildlife

In case you hadn’t realised Deanne, the Young ‘Un and I went to Australia for a month in March. This was partly to show the toddler off to the in-laws (Deanne is from Australia originally), partly because we hadn’t visited for five years and partly so we could all have a month off work/nursery and relax bit. I took the advice offered at the last Nottingham Type 1 Diabetes Group meeting by Dawn, she was rather handily (for me) talking about travelling with Diabetes. The main thing I was interested in, which she did actually mention was the fact that when she’s changing time zones she leaves her pump set on UK time until a few days have passed and she is more or less over the jet-lag. That may not be exactly what she said but that’s what I made it out to mean so that’s what I did.

The day of departure came and our bags were packed. My hand luggage obviously contained the requisite number of bags of Jelly Babies, a recently purchased Frio Insulin Travel Wallet (another suggestion from Dawn, thanks Dawn!), many, many infusion sets, insulin cartridges, blood test sticks and lancets and all the other Diabetes rubbish that we need to take when we go overseas. We arrived at Birmingham in plenty of time, which was lucky ’cause we had off site parking and had a bit of a job finding it, but then we got on the bus and it dropped us, with all our bags outside the main departures door at the airport.

The plane ride over was fine, although the service on the Birmingham to Dubai leg of the flight was less than we had hoped for, they (Emirates) hardly offered anything in the way of drinks (not talking alcoholic here, just water/soft drinks/etc.) and when the food eventually came they didn’t clear the trays up until about an hour later, which when you have a two year old makes doing anything in the already limited space available to you quite challenging.

Twenty odd hours after taking off we arrived in Perth. It was a bit of a change from the UK, it was about tea time when we arrived, eight or so hours ahead of the UK and the temperature was around 26 degrees (centigrade) when we left the airport. It was nice!

We actually went on a mini holiday the first few days we were there, drove a couple of hours south to Busselton which is a kind of hot version of Weymouth, only it’s nice! Being a bit further south the weather was nice but not too hot and we spent a lot of time going to chocolate shops and playing on the playground at the place we were staying at, it seemed to tire Deanne and myself out more than it did the Young ‘Un.

When we got back to Perth we had the important and serious task of meeting up with family and friends which included going to lots of parties and spending a lot of time sitting in coffee shops by the river. It was hard work! My control was relatively stable even though I was eating some pretty strange food. Certainly a lot better than the previous trip I had five years before where I was neither carbohydrate counting or dose adjusting (also didn’t have a pump at the time). Admittedly I had a few high blood sugars, seemingly for no reason although I worked out afterwards that it was actually due to ice cream cones which apparently had an awful lot more carb’s in than I was expecting (like 80 instead of 40 grams that I was guessing).

Me at Diabetes WA

Me at Diabetes WA

Anyway, once I had sorted that out everything went much better, I had a relatively low number of hypos and most of my blood sugars were below 12 with the exception of a few after meals out, however that happens to me in the UK too so it was nothing to do with being away. I even managed to do some Diabetes Web-Monkeying while I was away, I found a few bits and pieces in local papers and magazines which I posted on-line when I got the chance and also decided I’d go visit the local branch of Diabetes WA to find out what it’s like being Diabetic in Australia.

The main difference seems to be the fact that they don’t have a National Health Service, like what we do! Instead you have to take out health insurance which then covers the cost of a large percentage of the things you need as a Diabetic, e.g. needles, insulin, etc., etc., etc. They were very forthcoming and I in turn offered them some advice on how we use Twitter, Facebook and other on-line resources to keep in touch with people. It was interesting to speak to some people on the other side of the planet who have the same everyday problems and annoyances that we have over here.

After being on an insulin pump for over a year now my Diabetes certainly seemed to be a lot easier to manage and although I had highs and lows the way the pump adjusts them down and up again seems to be a lot more natural and my body seems to respond well to that, I don’t feel ill for hours after a high result and I don’t keep dropping and rising all day long like I did previously. I also feel like I can eat whatever I want while away and have almost got the hang of guessing carbs well enough to keep me fairly straight and narrow without needing to refer to my Carbs & Cals book all the time.

Now however I’m home again, in fact we got back about a month ago now and it’s taken me all this time to get this written down what with one thing and another including a Little ‘Un with chicken-pox, work, getting the house back to a manageable state after being away for a month and all those things you have to do upon returning from a long holiday.

The main difference between this trip to Aus’ and holidays I’ve had in the past is that whenever I’ve been overseas in the past I worried almost constantly about my control and about getting high or having hypos from having strange and exotic foods and experiences, this time however I didn’t worry, partly due to the pump, partly due to the fact that I have become a lot more confidant in controlling my diabetes with a pump than I ever was with injections and I guess mainly because when you have a toddler to look after you spend more time worrying about them than you do yourself!

We’ve already booked our next holiday in fact, we’re headed for Barcelona in the not too distant future, is there anything I’ll be doing differently because of my experiences down-under? Well no, the time away just went to prove to me that I am coping as well as I can with a chronic (/annoying) illness and all I need to improve even more is further practice. Which you only get by living it and doing things which you want to do rather than worrying about what might happen!

Unidentified Flying Illness

Unidentified Flying Bacteria

Unidentified Flying Bacteria

I’m Ill!

Okay that may seem like stating the bleeding obvious, however I’m not talking about my Diabetes, this is something new and frankly not super-comfortable. Let me tell you about it.

A couple of weeks ago we visited my parents in Dorset for the weekend, everything was fine until Saturday Morning when I started feeling a bit odd. Then at about ten or eleven in the morning I ran to the toilet and was ill. I continued to feel unwell for the rest of the weekend.

After getting home I forgot about it until the next weekend when I got a kind of pain under my ribs which lasted a good chunk of Saturday. We went to our neighbours’ house in the evening and frankly got a bit drunk, which was quite good fun, then on Sunday I didn’t feel great, which I put down to the alcohol I’d consumed, however I had a volleyball game on so I thought “self-inflicted, just put up with it” and played anyway (even with my ill-health and at-the-time-unrealised underlying health condition we won three sets to none – I actually played pretty well!!!).

Anyway, it got to Tuesday and as the day went on the pain under my ribs came back and I was having pains every time I took a deep breath in, coughed, sneezed or laughed…funny! I got myself to the NHS walk-in centre in town and got seen by a Nurse. Deanne had suggested it was Pleurisy but he discounted that because when he listened to my lungs they didn’t rattle, probably a good thing really.

After a bit of consultation he decided that it was possibly pancreatitis, caused by my recent-ish change in regime on to an insulin pump, he said this may have upset my pancreas due to the difference in my blood sugars and general control from being a bit random and bad to being quite well controlled.

This actually seemed to make a lot of sense to me but he said it was sensible if I went and saw my GP anyway so he booked me an appointment in the afternoon. I went and saw the GP and after a bunch of questions she decided that she wasn’t sure exactly what it was but that it may have something to do with my diaphragm and lungs or else something completely different so she gave me some pills called “lansoprazole” which seem to calm the acid in your stomach down so it doesn’t upset your other organs but sent me to the blood-letters at city hospital in the morning for a blood test just to discount the pancreatitis.

So currently I have no idea what’s wrong with me but still have pain and no idea when I’m likely to hear about my results.

Great!

In Bruges

Choco Story - A Chocolate Museum

Choco Story - A Chocolate Museum

We spent last weekend in Bruges in Belgium, a really nice place with lots of history and architecture and chocolate, all of which were nice!

The holiday got off to a positive start although the young ‘un was a bit unsettled on the trip over. We went by train from Nottingham to St. Pancr(e)as to Brussels and then caught another train to Bruges itself. It was quite a long trip what with all the waiting around for connections, he was really well behaved though.

Things were fine until we got there and got settled in then I did a blood test and it turned out I was 19.6 mmol/l…Oh dear, the next couple were higher at 19.9 then 21.3, in the morning I tested three times between half six and half eight and didn’t get under 10 on any of them. This was when I decided I’d change my insulin, infusion set and cannula, the next test I did two hours later at 10:40 was 3.3 so I’m guessing my suspicion was right and something was up with some aspect of my pump or my insulin.

The next day went pretty well and with most of my results being around 6 then on Monday another good day, I put it down to eating ice cream and chocolates!

Funnily enough the 23rd (Tuesday) was also pretty good but I did have one test out of the ordinary at 17.4 while travelling on the train again, I was worried that the Eurostar was having some kind of negative effect on my pump but my worries were unfounded as the next couple of tests were around 4.

Yesterday was our first full day at home and I came to work, dropping the little ‘un off at nursery, I decided that I would be good and start redoing fasting blood glucose tests so I started at 12 o’ clock and got the following results:

6.9 mmol/l

6.9 mmol/l

6.0 mmol/l

5.3 mmol/l

6.7 mmol/l

7.1 mmol/l

I figure this is close enough to no change for me to leave it alone so I will do my morning tests again next and then something which I have been putting off and off which is night time.

I’m pretty certain I need to do these as I am having more insulin at night than I need for my supper in order to get my BMs about right in the morning, I think this means that at some point at night my blood sugar is going up and therefore I need more insulin, working this out shouldn’t be too hard it just requires that I get up through the night and do blood tests every couple of hours.

Anyway I’m signing off again now, sorry about my lack of communication recently but I’ve been doing some coursework for a thing I’ve been doing at work, however I’ve finished this now and therefore will hopefully get a bit of spare time back in order that I can start putting a few more updates on here again.

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